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Biomedical subjects

F L Trowbridge

Publications and source records attributed to F L Trowbridge.

At least 37 records · Page 2Linked to original sources

Body composition of Peruvian children with short stature and high weight-for-height. I. Total body-water measurements and their prediction from anthropometric values.

Total body water (TBW) was measured by 18O dilution in 139 undernourished, preschool Peruvian children with high weight-for-height. Values for TBW as a percent of body weight were relatively high, averaging 67.4 +/- 6.4%. Depending upon the method of calculation, mean values for the sample population for percent fat ranged from 9.4-18.5%. Regression of TBW on lean body mass suggested that hydration of the fat-free body was higher than for normally nourished children of comparable age. Thus, the increased weight-for-height in these children did not result from increased fat tissue, but from increased hydration of the fat-free body. TBW was most highly correlated with height and weight, both with r = 0.95. Equations predicting TBW from either height or weight were significantly different from those developed by other investigators to predict TBW for normal, well-nourished American children.

Anthropometry↗

Body composition of Peruvian children with short stature and high weight-for-height. II. Implications for the interpretation for weight-for-height as an indicator of nutritional status.

In some child populations, low height-for-age, suggesting chronic undernutrition, may paradoxically be accompanied by relatively high weight-for-height, suggesting obesity. This growth pattern was investigated with anthropometric assessment and body composition studies using H2(18)O stable isotope dilution in 139 preschool-age Peruvian children. Results suggested low height-for-age (15th percentile National Center for Health Statistics [NCHS]) and high weight-for-height (60th percentile NCHS). Skinfold thicknesses were lower whereas arm muscle areas were more similar to NCHS reference values. Total body water (as percent body weight) was greater than reference values, consistent with lower body fat. Differences in body proportions did not account adequately for the high weight-for-height. The data suggest that the high weight-for-height in these children is not obesity but is associated with lower body fat and greater lean tissue or lean tissue hydration that may reflect dietary, environmental, or genetic influences. Weight-for-height cutoffs for wasting or obesity may require different interpretations for different populations.

Age Factors↗

Development of normalized curves for the international growth reference: historical and technical considerations.

The World Health Organization recommended in 1978 that the National Center for Health Statistics/Centers for Disease Control growth reference curves be used as an international growth reference. To permit the expression of growth in terms of standard deviations, CDC developed growth curves from the observed data that approximate normal distributions. Because of significant skewness, standard deviations for weight-for-age and weight-for-height were calculated separately for distributions below and above the median. Standard deviations below the median were calculated from the 5th, 10th, 25th, and 50th observed percentiles while those above the median were based on the 50th, 75th, 90th, and 95th observed percentiles. Height-for-age distributions did not show significant skewness, thus, the standard deviations were calculated based on all six of the above observed percentiles. The normalized reference curves provide a highly useful data base that permits the standardized comparison of anthropometric data from different populations.

Age Factors↗

Interpretation of Z-score anthropometric indicators derived from the international growth reference.

The WHO international growth reference was reviewed to identify characteristics that might affect the interpretation of anthropometric indicators derived from it. Discontinuities were found at the junction point of the two distinct data sets from which the reference curves are derived. Also, the Z-score derived percentile curves for weight-for-age and weight-for-height did not join due to differences in the variances of the two portions of the reference. Empirically an examination of data from international nutrition surveys revealed an artifactual drop in the prevalence of low height-for-age, low weight-for-height, and high weight-for-height at age 2 y, which is due substantially to these discontinuities rather than to intrinsic changes in nutritional status with age. Strategies are discussed for the interpretation of anthropometric indicators in light of these characteristics of the international reference.

Age Factors↗

Drinking-driving and health lifestyle in the United States: Behavioral Risk Factors Surveys.

National patterns of self-reported drinking-driving were examined using aggregated Behavioral Risk Factor Survey data. Drinking-driving is reported by 6.1% of U.S. adults, is almost three times more prevalent among men than women and is most prevalent in 18-24-year-old men (15.4%). Sociodemographic characteristics of self-reported drinking drivers correspond with those characteristics based on alcohol-associated motor vehicle accident and arrest data. Heavy smokers and those who fail to use seatbelts are more likely to drink and drive than those without these health-risk behaviors. Men reporting stress in interpersonal relationships are more likely to drink and drive. Individuals who drink or smoke in response to stress are more likely to drink and drive than those who exercise in response to stress. The concurrent practice of drinking-driving with lack of seatbelt use, use of alcohol in response to stress and smoking probably contributes substantially to the risk of accident and serious injury among drinking drivers and has implications for both prevention and treatment programs.

Accidents, Traffic↗

Alcohol and body weight in United States adults.

Alcohol contributes more than 10 per cent of the total caloric intake of adult drinkers in the United States. However, the effect of alcohol on body weight has not been adequately studied in the general population. The association between weight and frequency of alcohol consumption was examined in two national cross-sectional surveys: the Second National Health and Nutrition Examination Survey (HANESII; n = 10,929) and the Behavioral Risk Factor Surveys (BRFS; n = 18,388). Linear multiple regression was used to estimate the independent effect of alcohol on weight, adjusting for smoking, age, diet practices, physical activity, race, education, and height. Among men, alcohol had only a slight effect on weight in either survey. However, among women, alcohol was associated with a substantial reduction in weight, which was as large as the effect of smoking. Compared with nondrinkers, women who consumed alcohol 7-13 times per week had the greatest reduction in weight: -3.6 kg (95% confidence limits [CL] = -5.6, -1.5 kg) in HANESII and -3.2 kg (95% CL = -4.9, -1.5 kg) in BRFS. Alcohol confounded the association between smoking and weight, and among women it accounted for nearly 45 per cent of the weight-lowering effect of smoking. Alcohol also diminished the weight-lowering effect of smoking in men, while in women the smoking effect was slightly enhanced. Further studies are needed to understand the causal mechanisms by which alcohol is associated with body weight.

Adult↗

Evaluation of reactions to food additives: the aspartame experience.

Despite the widespread use of chemical food additives, few criteria exist to evaluate consumer reports of adverse reactions. We analyzed 231 consumer complaints associated with the food additive aspartame. We developed a methodologic approach to evaluate all complaints by adapting general criteria used to investigate adverse reactions to medications. Complaints were ranked according to the effects of cessation and rechallenge. Using this method, we found no clear symptom complex that suggests a widespread public health hazard associated with aspartame use; however, we identified some case reports in which the symptoms may be attributable to aspartame in commonly-consumed amounts. The systematic application of pre-defined review criteria, such as those described here, to monitor consumer complaints related to food additives will help identify products that warrant more focused clinical studies.

Adult↗

Seasonal differences in breast-feeding in rural Egypt.

Two surveys in Upper and Lower rural Egypt allowed an analysis of the seasonality of infant feeding. The first, including 937 children, was conducted during the relatively cool season of low diarrhea incidence in January-April 1978; the second, including 976 children, took place during the hot season of high diarrhea incidence in August-September 1980. Of infants 6-11 mo old, the proportion exclusively breast-feeding was greater in the hot-season survey (40% vs 16% in Lower Egypt, p less than 0.01; 36% vs 22% in Upper Egypt, p less than 0.01). Of children 12-17 mo old, a higher proportion were completely weaned during the hot season in Lower Egypt only (28% vs 14%, p less than 0.01). This difference was explained by an increase in pregnancy rates during the hot season resulting in less breast-feeding. Seasonal variation must be considered in the interpretation of infant-feeding surveys.

Breast Feeding↗

Overweight adults in the United States: the behavioral risk factor surveys.

Using data on 19,405 adults from telephone interviews across the US, 1981-1983, we examined the sociodemographic characteristics, health-risk behaviors, body image, and dieting of overweight adults classified by the 1959 Metropolitan Life Insurance tables for weight and height. By self-report, 23% were overweight vs 29% in 1960-62. This modest decline in overweight remained after age-adjusting the 1981-1983 rate to the 1960 population. In 1981-1983, more blacks and Hispanics than whites were overweight [rate ratio (RR) = 1.43]. After adjustment for age and education, more over- than average-weight adults had uncontrolled hypertension, were binge drinking, and had a sedentary lifestyle. Among overweight men and women, 72% and 52%, respectively, were not dieting. Overweight adults acknowledging they were overweight were dieting more often than those without this perception (RR = 1.53). Results are discussed in light of research documenting weight gain and overweight as independent risk factors for cardiovascular disease incidence and mortality.

Adult↗

Ethnic group differences in nutritional status of young children from low-income areas of an urban county.

A nutrition assessment survey was undertaken among 566 preschool children from randomly selected low income households located within an urban county. The purpose of the survey was to determine the prevalence of selected nutrition problems and to identify relationships among ethnic and economic variables and nutritional status. Underweight was identified in 1.8%, overweight in 15.4%, and short stature in 13.1% of children. Southeast Asian children had a higher prevalence of short stature than the other ethnic groups. Low hemoglobin values were identified in 4.3%, low hematocrit in 6.9%, and elevated erythrocyte protoporphyrin in 6.0% of children. The prevalence of elevated EP was significantly higher among Southeast Asian children than non-Southeast Asians and likely was due to iron deficiency. Results of the survey suggest that Southeast Asian children constitute the group at highest nutritional risk in the low income areas surveyed.

Child↗

Body water measurements in premature and older infants using H218O isotopic determinations.

Total body water was measured by H218O stable isotope dilution in two groups: in premature infants without complications, who were studied from 8 d of age until discharge; and in Peruvian subjects aged 6-36 mo, who were in the long-term convalescent stage of recovery from malnutrition. Results indicated that reliable total body water estimates can be obtained from sample volumes as small as 50 microliters of urine or plasma using a gas-isotope-ratio mass spectrometer equipped with an automated purification inlet system. Results from 21 studies in 10 Peruvian infants indicated substantially completed isotope equilibration in plasma by 2 h after the dose; total body water estimates from the 2-h samples averaged 98.7% (+/- 4.1) of 6-h values. Samples obtained at 4-h postdose gave total body water estimates that averaged 99.0% (+/- 2.9) of the 6-h value, showing essentially complete equilibration and reduced variability. Total body water estimates from urine samples collected 3-5 h postdose were closely correlated with 6-h, plasma-based total body water values in both premature and older infants; however, some reduction in variability was observed when urine collection was extended to 5-7 h, at which time urine-based estimates averaged 98.8% (+/- 2.0) and 100.7% (+/- 3.1) of plasma-based values for prematures and older Peruvian infants, respectively. The correlation between 5-7 h urine-based estimates of total body water with plasma-based values was r = 0.96 for 30 studies in prematures and r = 0.99 for 57 studies in older Peruvian infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Composition↗

Prevalence of growth stunting and obesity: Pediatric Nutrition Surveillance System, 1982.

Pediatric surveillance data for 1982 are examined in terms of the prevalence of growth stunting and obesity. Results indicate that growth stunting is observed in approximately 6%-16% of children in the age group from birth through 4 years. Overall, the prevalence of stunting trends to increase with age. Native American and Hispanic children show the highest prevalence of stunting. Obesity is observed to vary from 5%-13% in different age and ethnic subgroups. Obesity increases in prevalence among 1-year-olds relative to infants less than 1 year of age, but from 2-4 years of age there are no consistent trends in the prevalence of obesity with increasing age. Native American children, followed by Hispanic children, have the highest prevalence of obesity as reflected in high weight-for-height. The prevalence of growth stunting and obesity in the populations under surveillance is greater the 5% level "expected" when compared with the reference population, suggesting that the children attending publicly supported health programs are at increased nutritional risk. At the same time, the prevalence of low weight-for-height is generally less than the 5% level, suggesting that thinness is not a significant public health program in the populations under surveillance. The observation of increased stunting as well as high weight-for-height among Hispanic and Native American children raises a number of issues in interpretation and suggests that the diet of these children may be relatively adequate in quantity but inadequate in quality of nutrient intake.

Black People↗

Arm muscle indicators and creatinine excretion in children.

The ability of anthropometric measurements, including arm muscle area calculated from arm circumference and triceps skinfold thickness, to estimate creatinine excretion as an index of muscle mass was tested in 14 fully active children, 2 to 6 yr of age in a residential care facility. The children were placed on a meat and fish-free diet for 36 to 48 h before the determination of mean creatinine excretion during three 24-h urinary collections. Results indicated highly significant correlations between mean creatinine excretion and height (r = 0.71), weight (r = 0.69), and arm circumference (r = 0.63). However, arm muscle area had the highest correlation with creatinine excretion (r = 0.86) of any anthropometric variable used. Step-wise multiple-regression analysis indicated that including height or weight with arm muscle area did not significantly improve the estimation of creatinine excretion, but that weight for height added significantly to improve the estimation of creatinine excretion, but that arm muscle area can provide a useful index of body muscle as reflected in urinary creatinine excretion in young children.

Arm↗

Results of nutritional status surveillance in El Salvador, 1975-77.

Nutritional status surveillance data based on the clinical diagnosis of malnutrition and on weight-for-age, as well as diarrhoeal disease data for preschool age children attending government health clinics in El Salvador are presented for a 3-year period (1975 - 77). Surveillance results indicated consistently higher rates of clinical malnutrition and weight-for-age deficit in rural children as compared with urban children, and higher malnutrition rates in children 1 - 4 years of age as compared with infants less than 1 year old. Consistent seasonal increases in malnutrition were observed that were most pronounced in older preschool children (1 - 4 years) in rural areas. Seasonal peaks in malnutrition consistently followed 1 - 2 months after the major seasonal peak in diarrhoea at the onset of the rainy season, suggesting that diarrhoea may play a role in the etiology of malnutrition. A secondary seasonal peak in diarrhoea in the cooler, dry season was most prominent in infants but was not related to increased malnutrition. These results indicate that nutritional and health status indicators formed from data collected regularly at health centres can demonstrate consistent age group, urban/rural, and seasonal differences in nutritional status that may be useful in identifying risk groups and in monitoring nutritional changes for planning and evaluation purposes.

Body Weight↗